Metabolic Hormone Profiles in Breast Milk From Mothers of Moderate-Late Preterm Infants Are Associated With Growth From Birth to 4 Months in a Sex-Specific Manner

Laura Galante; Clare M Reynolds; Amber M Milan; Tanith Alexander; Frank H Bloomfield; Yannan Jiang; Sharin Asadi; Mariana Muelbert; David Cameron-Smith; Shikha Pundir; Mark H Vickers; DIAMOND study team

doi:10.3389/fnut.2021.641227

Metabolic Hormone Profiles in Breast Milk From Mothers of Moderate-Late Preterm Infants Are Associated With Growth From Birth to 4 Months in a Sex-Specific Manner

Front Nutr. 2021 May 28:8:641227. doi: 10.3389/fnut.2021.641227. eCollection 2021.

Authors

Laura Galante¹, Clare M Reynolds^{1

2}, Amber M Milan^{1

3}, Tanith Alexander^{1

4}, Frank H Bloomfield¹, Yannan Jiang^{1

5}, Sharin Asadi¹, Mariana Muelbert¹, David Cameron-Smith^{1

6}, Shikha Pundir¹, Mark H Vickers¹; DIAMOND study team

Affiliations

¹ The Liggins Institute, University of Auckland, Auckland, New Zealand.
² School of Public Health, Physiotherapy and Sports Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Ireland.
³ Food Nutrition & Health Team, Food & Bio-Based Products Group, AgResearch, Palmerston North, New Zealand.
⁴ Neonatal Unit, Kidz First, Middlemore Hospital, Auckland, New Zealand.
⁵ Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand.
⁶ Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.

Abstract

Background: Differing environmental conditions experienced by mother-infant dyads may influence composition of the milk received by the infant. As a consequence, diverse milk compositional profiles may contribute to different postnatal outcomes, especially in infants facing adverse perinatal environments. We investigated whether variability in milk concentrations of key metabolic hormones is associated with different growth outcomes in infants born preterm, a perinatal complication known to impact on infant growth. Methods: Human milk samples were collected from 169 mothers of 191 infants enrolled in the DIAMOND trial, a randomized trial of nutrition for moderate-late preterm infants, at 5 and 10 days postpartum and again at 4 months' corrected age and analyzed for leptin, adiponectin and insulin-like growth factor (IGF)-1. Infant weight and body composition were measured at birth, discharge and 4 months' corrected age. Multiple linear regression models were used to examine correlations between milk hormone concentrations, weight z-scores and body composition at discharge and 4 months' corrected age, and weight gain from birth to 4 months' corrected age. Sex-specific interactions were examined. Results: Higher milk IGF-1 concentrations on day 5 after birth were associated with greater infant fat-free mass at 4 months' corrected age. Milk IGF-1 concentrations at 4 months were positively associated with fat mass and fat-free mass at 4 months in boys but not girls. Milk leptin concentrations on day 5 after birth were positively associated with fat mass at discharge from hospital, but negatively associated with fat mass at 4 months' corrected age. No significant association was found for milk adiponectin concentrations. Conclusion: Milk IGF-1 and leptin concentrations in mothers of moderate-late preterm babies are associated with different growth and body composition through to 4 months' corrected age and these associations are often different in boys and girls. The sex-specific effects of nutrient and hormone exposure during early life in preterm infants warrants further investigation to optimize the nutritional care these infants receive, particularly in hospital, where the same nutrition is provided to boys and girls.

Keywords: IGF-1; adiponectin; breastfeeding; breastmilk; growth trajectories; human milk; leptin; pre-term birth.